A Cook County Hospital Emergency Medicine Blog for up-to-date medicine and more.
You’re sitting by the EMS radio when a call comes in: 56 y/o male with no reported PMHx presenting with facial swelling that started earlier this morning. His lips are so swollen that he’s having some trouble controlling his secretions. He received epinephrine and diphenhydramine en route without too much improvement.
Nanditha Ravichandran MD and Eric Leser MD
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Clinical Question: How does Neffy (epinephrine nasal spray) compare to the Epinephrine autoinjectors?
Joanne Routsolias, PharmD
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Imagine. You're on a busy red team shift. A clinic calls to send a patient with asymptomatic hyperglycemia to the ED. You roll your eyes, transfer it to the attending. The patient of course lands in the resus bay and you go to evaluate them. Their sugar is 450 mg/dL, they have no symptoms and their vitals are normal. You mindlessly order a VBG, basic labs and a liter of fluid and move on with your day. However, is this all necessary? What should our end goal be? What should I choose as my intervention if necessary? Do I even need labs?
Kathryn McGregor MD, Joanne Routsolias PharmD, and Eric Leser MD
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